Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic kidney disease (CKD) is now an accepted long-term complication of allogeneic hematopoietic stem cell transplantation. Calcineurin inhibitors (CNI), which are used for prophylaxis and treatment of graft-versus-host disease (GVHD), have been associated with the development of nephrotoxicity. Hypertension (HTN) and thrombotic microangiopathy (TMA) are 2 comorbidities linked to CKD. T cell depletion (TCD) of stem cell grafts can obviate the need for the use of CNI. We conducted a retrospective analysis of 100 patients who underwent TCD transplantation: 30 in group A were conditioned without total-body radiation (TBI) and 70 in group B received a TBI containing regimen. None of the patients received CNI. The median age was 55.5 and 45 years for groups A and B, respectively. Eleven patients developed TMA, all in group B. The 2-year cumulative incidence of sustained CKD was 29.2% and 48.8% in group A and group B, respectively, with a mean follow-up of at least 21 months. CKD free survival was better in the non-TBI group (P = .046). Multivariable survival analysis revealed that exposure to TBI, older age, and TMA were risk factors for CKD. The incidence of new onset or worsening HTN was 6.7% and 25.7% (P = .03) in group A and B, respectively. The use of TBI (P = .0182) and diagnosis of TMA (P = .0006) predisposed patients to the development of HTN using univariable logistic regression models. Thus, despite the absence of CNI, a proportion of these older patients in both groups developed CKD and HTN.
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PMID:Chronic kidney disease, thrombotic microangiopathy, and hypertension following T cell-depleted hematopoietic stem cell transplantation. 2015 36

Chronic kidney disease (CKD) is a recognized risk multiplier for the development of cardiovascular disease (CVD), with CVD events representing the leading cause of morbidity and mortality in patients with CKD. The nature of CKD as a risk state relates both to the nature of CKD and the antecedent development of CVD. In addition, patients with CKD have increased rates of multiple conventional cardiac risk factors. Although early data regarding the relationship between CVD and CKD were limited because of the need for large data sets and multivariable analysis, the importance of recognizing this complex relationship is now clear. The essence of the relationship appears to be bidirectional, and therapy directed at improving natural history of chronic disease on one system generally improves prognosis in the other. Specifically, CVD outcomes have been shown to improve with the treatment of risk factors commonly found in association with CKD, including hypertension, diabetes, dyslipidemia, albuminuria, and smoking, as well as appropriate renin-angiotensin-aldosterone system blockade and antiplatelet therapy. Once hospitalized, management of acute coronary syndromes represents a key area of clinical investigation. The goal of this article is to highlight the importance of these topics in improving cardiovascular outcomes and use of appropriate treatment in CKD.
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PMID:Cardiorenal interaction: appropriate treatment of cardiovascular risk factors to improve outcomes in chronic kidney disease. 2020 53

Chronic kidney disease (CKD) is associated with a higher risk for stroke in studies from developed countries. This prospective study was conducted to study the clinical profile, management, and outcome of stroke in patients of chronic kidney disease who had been admitted in our institute during the period from December 2004 to December 2006. A higher incidence of stroke was found in men and in the fifth decade of life. Hypertension and diabetes were found in 88.8 and 48.1% of the patients respectively. CKD was detected for the first time during stroke evaluation in 55.5% of the patients. Stroke was due to cerebral infarction in 48.14% and due to cerebral hemorrhage in 40.7% of the patients. Surgical intervention was needed in 14.8% of all patients while stroke was managed medically in the rest. Over 70% of the patients were discharged after they showed improvement in the symptoms.
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PMID:Stroke in chronic kidney disease. 2035 3

Chronic kidney disease (CKD) is a worldwide public health problem. Little is known about its burden in Africa. This paper reviews the knowledge of CKD in Kinshasa, summarizing four studies undertaken in the general population and traditional health system of Kinshasa. CKD was defined by either kidney damage (proteinuria> or =300 mg/day) or reduced kidney function (eGFR<60 ml/min/1.73 m(2)). In the general population, the prevalence of CKD all stage is 12.4 %. Our work shows also the high prevalence of proteinuria among subjects who do not have diabetes or hypertension, the lack of early detection and management of CKD risk factors in the traditional health care system leading to late referral or premature deaths, and the limits of renal replacement treatment. CKD affects young people in the DRC, in contrast to the United States, where CKD is more prevalent in older people. Major determinants of CKD in our studies were hypertension, diabetes, overweight, age, lower socioeconomic status, and Human immunodeficiency virus (HIV) infection. Glomerular nephropathy (mainly focal segmental glomerulosclerosis) remains the leading cause of end stage renal disease. An annual screening of the population for proteinuria and CKD risk factors is feasible and will, it is hoped, provide the basis for building a nationwide prevention strategy.
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PMID:[Epidemiology of chronic kidney disease in the Democratic Republic of Congo: review of cross-sectional studies from Kinshasa, the capital]. 2040 70

Chronic kidney disease (CKD) is a global public health concern, and there is emerging a strong relationship between CKD and increased cardiovascular disease (CVD) risk. CKD in the presence of other co-morbidities such as type 2 diabetes mellitus (T2DM) and hypertension (HTN) can lead to early progression to end-stage renal disease (ESRD/stage V CKD) and confer a greater risk for CVD morbidity and mortality. CVD events are the leading cause of premature death in patients with CKD, even before their progression to ESRD, with the rate of CVD progression being twice as common compared with the general population. The higher mortality from CVD persists even after adjusting for most of the traditional risk factors, suggesting the possible contributions of uremia-related, nontraditional risk factors. This has led to the current understanding that the pathophysiology of CVD in CKD involves a complex interplay of both the traditional as well as nontraditional, uremia-related risk factors. This review will elaborate on the pathophysiology of CVD in CKD and will discuss the role of microalbuminuria (MAU)-proteinuria as a potential diagnostic and prognostic tool for CVD in CKD risk assessment.
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PMID:Chronic kidney disease and cardiovascular risk. 2040 50

In recent years, there has been a general recognition of the importance of tackling noncommunicable chronic diseases throughout the world and not just in developed nations. Chronic kidney disease (CKD) is increasingly recognized as a public health threat, based on its high prevalence, rising incidence, associated complications, and cost. It is imperative that nations develop screening and surveillance programs related to CKD. This article provides a global perspective on existing and emerging CKD surveillance efforts. A variety of programs are described, ranging from cross-sectional screening studies to determine CKD prevalence; targeted screening of high-risk populations presenting for voluntary testing; to more systematic surveillance within the scope of integrated health care systems in many developed nations. The choice of surveillance programs for many countries will depend on available resources and competing health care priorities. Integration with surveillance programs for other major chronic diseases such as diabetes, hypertension, and obesity is highly desirable and could be a key to the prevention of CKD. Finally, we propose the model of integrated health systems as one that is perhaps best suited to systematic, longitudinal surveillance of many chronic diseases, a model based on a national electronic health care record with linkage across primary care and hospital-based programs. Robust health education efforts and timely dissemination strategies will remain the key to the success of disease surveillance. It is gratifying to note that more and more countries are developing and adopting CKD surveillance programs as part of national disease prevention strategies.
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PMID:Surveillance of chronic kidney disease around the world: tracking and reining in a global problem. 2043 96

Chronic kidney disease (CKD) is a widespread health problem in the world and anaemia of renal origin is a common problem. Anaemia associated with CKD covers significant risk for faster progression of chronic renal failure, decreased quality of life, and clinical manifestation of cardiovascular disease. The mainstay of anaemia treatment secondary to end-stage renal disease (ESRD) has become erythropoiesis stimulating agents (ESAs). More than 90 % of ESRD patients maintained on dialysis respond to traditional recombinant human erythropoietin (rHU EPO) or to EPO analogues, also called "biosimilars". Iron deficiency often co-exists in dialysis patients and must be evaluated and treated to reduce ESA requirements. Partial, but not complete correction of renal anaemia is associated with improved outcomes in patients with CKD. The use of ESAs does carry risks such as hypertension, pure red cell aplasia, or cancer, and these agents need to be used judiciously.
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PMID:Erythropoiesis stimulating agents and anaemia of end-stage renal disease. 2044 66

Chronic kidney disease (CKD) has been recognized as a significant public health problem, with 20 million Americans, or 11% of the adult population, currently living with CKD. Life expectancy in patients with CKD is limited by the development of disturbances of mineral metabolism, which occurs in virtually all patients during the progression of their disease, and is associated with bone loss and fractures, cardiovascular disease, immune suppression, and increased mortality. As kidney disease develops, there is decreased functional renal mass and a reduction in renal 1alpha-hydroxylase activity and thus in renal production of calcitriol at very early CKD stages. Recently, a potentially important role of vitamin D receptor activation (VDRa) in the survival of patients undergoing dialysis has been suggested. Beyond the effect on parathyroid hormone suppression, the pleiotropic effect of vitamin D has been associated with improvement of cardiovascular risk factors, including increased renin activity, hypertension, inflammation, insulin resistance, diabetes, and albuminuria. However, the current K/DOQI and KDIGO recommendations limit the administration of VDRa agents for treatment of hyperparathyroidism only. The role of vitamin D administration in the different CKD stages will be discussed in this review.
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PMID:Use of vitamin D in chronic kidney disease patients. 2050 58

Renal impairment may be evident at any stage of heart failure (CHF). Up to 30% of patients with heart failure have abnormal renal function. Chronic kidney disease (CKD) can be a complication of heart failure and chronic heart disease can be a consequence of CKD. Members of the multidisciplinary team, such as nurses, dieticians and physiotherapists should be encouraged to maximise their knowledge and skills across disease areas to influence and improve outcomes of those with CKD and CHF. In particular management of fluid balance, blood pressure control/monitoring, discussion of blood results and reduction of cardiovascular risk factors. Close monitoring and effective management of modifiable cardiac risk factors, such as diabetes and hypertension can reduce onset and slow progression of CKD. This can be done by applying the key principles of good practice, such as communication between healthcare professionals, patient education and empowerment alongside early identification and management of symptoms of CKD and CHF.
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PMID:Heart failure and chronic kidney disease: an integrated care approach. 2058 8

Chronic kidney disease (CKD) has emerged as a global public health burden. Taiwan has the highest incidence and prevalence rates of end-stage renal disease (ESRD) in the world. In this review, the following key issues of CKD in Taiwan are addressed: epidemiological data, underlying diseases patterns, risk factors, public health concerns and a preventive project. Prevalence of CKD are reported to be 6.9% for CKD stage 3-5, 9.83% for clinically recognized CKD and 11.9% for CKD stage 1-5. However, overall awareness of CKD is low, 9.7% for CKD stage 1-3 and 3.5% for stage 1-5. Diabetes mellitus (43.2%), chronic glomerulonephritis (25.1%), hypertension (8.3%) and chronic interstitial nephritis (2.8%) are four major underlying renal diseases of ESRD. Older age, diabetes, hypertension, smoking, obesity, regular use of herbal medicine, family members (both relatives and spouses), chronic lead exposure and hepatitis C are associated with higher risk for CKD. Impact of CKD increases risk of all-cause mortality and cardiovascular diseases, especially in those with overt proteinuria and advanced CKD stages. These impacts lead to increased medical costs. The nationwide CKD Preventive Project with multidisciplinary care program has proved its effectiveness in decreasing dialysis incidence, mortality and medical costs. It is crucially significant from Taiwan experience on CKD survey and preliminary outcome of the preventive project. Provision of a more comprehensive public health strategy and better care plan for CKD should be achieved by future international collaborative efforts and research.
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PMID:Epidemiology, impact and preventive care of chronic kidney disease in Taiwan. 2058 40


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